The purpose and principles of the AIP diet
The Autoimmune Protocol (AIP) is a stricter version of the Paleo diet, developed to address the specific needs of individuals with autoimmune conditions. The rationale behind AIP is based on the connection between the immune system, inflammation, and gut health.
For those with an autoimmune disorder, the immune system mistakenly targets the body's healthy tissues, causing chronic inflammation. Research indicates that many individuals with these conditions also have a highly permeable intestinal lining, often referred to as 'leaky gut'. This permeability may allow food particles and toxins to cross into the bloodstream, triggering or exacerbating an inflammatory immune response.
The AIP diet works in three distinct phases to identify and manage these dietary triggers. By removing potentially inflammatory foods and focusing on nutrient-dense options, the diet aims to support gut healing, reduce systemic inflammation, and allow the immune system to recalibrate. This process helps individuals understand their specific food sensitivities and develop a sustainable eating plan to manage their symptoms effectively.
The three phases of the autoimmune elimination diet
Phase 1: The elimination phase
This is the most restrictive part of the protocol, lasting for a minimum of 30 to 90 days, or until a significant and noticeable reduction in symptoms occurs. During this time, the goal is to completely remove all common dietary inflammatory triggers. The foods to avoid include:
- Grains: Wheat, rice, oats, corn, barley, and related products.
- Legumes: Beans, lentils, peas, peanuts, soy, and all derivatives like tofu or hummus.
- Dairy: Cow, goat, or sheep milk and products such as cheese, yogurt, and butter.
- Eggs: Both whites and yolks.
- Nightshade vegetables: Tomatoes, potatoes, eggplants, and peppers, as well as spices derived from them.
- Nuts and seeds: Including coffee and seed-based spices.
- Refined sugars and processed foods: Including most additives and artificial sweeteners.
- Alcohol and coffee: Both are eliminated.
During this phase, the diet is built around a wide variety of nutrient-dense, anti-inflammatory foods. Allowed foods include leafy greens, most fruits in moderation, high-quality animal proteins, organ meats, bone broth, and healthy fats from sources like avocados and olives.
Phase 2: The reintroduction phase
After achieving a period of reduced symptoms, you can begin the systematic reintroduction of eliminated foods. This is a careful, one-at-a-time process designed to observe your body's specific reactions. A typical reintroduction test takes about 5 to 7 days for each new food. The recommended procedure is as follows:
- Test: Eat a small portion (e.g., a teaspoon) of the food and wait 15 minutes to monitor for immediate reactions.
- Monitor: If no immediate reaction occurs, have a slightly larger portion and wait 2-3 hours.
- Observe: If you still have no symptoms, eat a normal-sized portion and then completely avoid the food for the next 5-7 days.
- Assess: If no symptoms appear during the observation period, the food is likely well-tolerated and can be incorporated back into your diet. If symptoms return, you will continue to avoid it.
Phase 3: The maintenance phase
This final, long-term phase involves incorporating the knowledge gained from the previous stages into a sustainable, personalized diet. You will continue to avoid the foods identified as triggers during reintroduction, while enjoying a broader and more diverse diet rich in nutrient-dense foods. This phase is focused on maintaining your improved health, not on remaining indefinitely in the highly restrictive elimination stage.
AIP vs. standard elimination diets and the Paleo diet
While sharing some similarities, the AIP diet is distinct due to its specific focus on autoimmune disease and a more stringent approach.
| Feature | Autoimmune Protocol (AIP) Diet | Standard Elimination Diet | Paleo Diet |
|---|---|---|---|
| Targeted Conditions | Specifically for autoimmune diseases and severe inflammation. | Broader use for identifying general food sensitivities (e.g., IBS, migraines). | Based on ancestral eating patterns, not specific to autoimmune issues. |
| Key Differences | Stricter and more comprehensive elimination phase, including nightshades, nuts, and seeds. | Typically less restrictive, focusing on common allergens like dairy and gluten. | Less restrictive than AIP; allows eggs, nuts, and seeds from the start. |
| Phases | Defined phases: Elimination, Reintroduction, and Maintenance. | Also involves elimination and reintroduction, but with less structure than AIP. | Generally a long-term dietary pattern, not a phased process. |
Scientific evidence and benefits
Although research on the AIP diet is still emerging, several small studies show promising results for specific autoimmune conditions, demonstrating its potential to reduce inflammation and improve quality of life.
- Hashimoto's Thyroiditis: In one study, women with this condition who followed an AIP program experienced a significant decrease in symptoms and inflammatory markers, along with an improved quality of life.
- Inflammatory Bowel Disease (IBD): Small studies have shown that patients with IBD, including Crohn's disease and ulcerative colitis, reported significant improvements in symptoms after following the AIP diet for several weeks.
- Gut Health: The diet's emphasis on eliminating irritants and promoting nutrient-dense foods supports the hypothesis of repairing the intestinal lining and balancing the gut microbiome, which is central to the AIP's mechanism.
Despite positive outcomes in smaller studies, more extensive research is needed to fully understand the effects of AIP across various autoimmune diseases.
Who should try the AIP diet?
The AIP diet is not for everyone and is best suited for individuals with a confirmed autoimmune condition who have not found sufficient relief from conventional treatments or less restrictive dietary changes. It is highly recommended to undertake this protocol under the supervision of a healthcare provider or a registered dietitian, particularly for those who are underweight, malnourished, or pregnant. A professional can help ensure you meet your nutritional needs, manage the process safely, and interpret your body's reactions accurately.
The challenge and reward
The AIP diet can be challenging due to its restrictive nature, but the potential for symptom reduction and improved quality of life can be highly motivating. By methodically identifying and eliminating personal food triggers, individuals can gain a deeper understanding of their body and what it needs to thrive. The ultimate goal is not permanent restriction but a personalized, sustainable maintenance diet that minimizes inflammation and supports long-term wellness. For more insights into the process, personal accounts and resources can be found through communities like Autoimmune Wellness.
Conclusion
What is the autoimmune elimination diet? It is a structured and rigorous, phased dietary approach aimed at identifying food sensitivities and reducing the inflammatory response in autoimmune diseases. By focusing on nutrient-dense, gut-healing foods during a temporary elimination phase, and systematically reintroducing foods to test for individual triggers, the AIP diet helps create a personalized, long-term dietary plan. While the initial phase is restrictive, it empowers individuals to take control of their health by understanding their unique relationship with food, with a growing body of evidence supporting its efficacy for specific conditions like IBD and Hashimoto's.
